Cholestasis of pregnancy is a liver disease that causes severe itching and occurs in late pregnancy due to hormones affecting bile flow. It is diagnosed through blood tests and can increase the risk of fetal distress, prematurity, and stillbirth. Treatment is difficult, but childbirth usually resolves the issue. Topical ointments and ursodeoxycholic acid may be prescribed, and dandelion can promote liver health. Relapses are common in subsequent pregnancies.
While many pregnant women experience annoying itching at some point during their pregnancy, the problem is usually superficial. Cholestasis of pregnancy, however, is a type of liver disease that causes severe itching. It only occurs in pregnant women, usually in late pregnancy.
The hormones associated with pregnancy affect the flow of bile through the gallbladder, slowing or even stopping it. The bile acids then build up in the liver and leak out into the bloodstream. It is estimated that one in 1,000 pregnancies are diagnosed with this condition.
Symptoms of cholestasis of pregnancy include severe itching, most often in the feet and hands. A woman’s urine may be darker in color, while her bowel movements may be lighter than usual. You may experience abnormal tiredness, decreased appetite and even depression. Some women also show jaundice or nausea.
Risk factors for this condition include multiple pregnancies, previous liver damage, and a family history of the condition. Studies have shown that women of Swedish or Chilean descent also have an increased risk of developing cholestasis of pregnancy. A diagnosis is made by studying the patient’s medical history and doing blood tests to evaluate liver function and bile acid and bilirubin levels.
Cholestasis of pregnancy is a potentially serious condition for both mother and baby. Pregnancies diagnosed with the condition have a higher chance of fetal distress, prematurity, and stillbirth. Since the mother is unable to process the bile properly, she puts an extra load on the baby’s liver. Birth is usually induced as soon as the baby is full-term or otherwise considered safe to deliver. Dexamethasone is usually given to help the baby’s lungs develop if the baby is premature.
It is difficult to treat this condition – usually only childbirth will fix it. It usually clears up on its own within several days of delivery. Treatment during pregnancy is usually to relieve severe itching. Topical ointments can help.
Ursodeoxycholic acid, a drug that helps lower bile acids, may be prescribed to a woman with cholestasis of pregnancy. Dandelion is a natural remedy that has been shown to promote liver health. Some studies report that up to 90 percent of women who have had the condition will suffer relapses with subsequent pregnancies.
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